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DocuSign Envelope ID:294BB418-E1F3-4C25-885F-5006334D0849 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: PLM Equipment Services Party/Vendor Contact Person: Pam Mims Contact Phone: 919- <br /> 233-2231 Party/Vendor Address: 212 Powell Dr Suite 122 City Raleigh State: NC Zip: 27606 Department: <br /> Emergency Services Amount: $6,085.00 Purpose: Equipment maintenance for ambulances Budget Code(s): <br /> 10757520-571000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date April 30, 2020 Approved by Board <br /> Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> UocuSigned by: <br /> Department Director's Signature Date: 5/3/2020 <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: �ocu5igned by: <br /> 1 <br /> Office of the the Chief Financial Officer 7o4E5�s1ACC1409... Date: 5/5/2020 <br /> LeEal Services <br /> This agreement is approved as to legal form and suffic Oocusigned dy: <br /> 5/5/2020 <br /> Office of the County Attorney Date: <br /> 4635C68304CA4M... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 11/19 <br /> 8 <br />